Total knee arthroplasty (TKA) is an effective surgical procedure for relieving pain in patients with severe knee arthritis or injury. Despite excellent log term survivorship, more than a third of TKA patients report limited functional improvement and many are dissatisfied with their outcomes. Little is known about why some TKA patients achieve a successful outcome while others do not, emphasizing the need for increased research. The purpose of the proposed conference is to bring together clinicians and scientists to exchange ideas and strategies based on their shared interest in improving TKA outcomes. The conference will be focused on research efforts in three areas most likely to bear fruit in improving outcomes and lessening complications that are associated with this procedure. The first two areas involve two common reasons for TKA failure: infection and instability. Periprosthetic infection places an overwhelming personal burden on the TKA patient and an economic burden to society that threatens the management of this patient population. Joint instability after TKA leads to dissatisfaction by causing pain and limiting the patient's activities. The third area deals with th use of patient-reported measures to inform the need for and timing of TKA and to evaluate TKA outcomes. Significant variations exist in patient-reported outcomes, and these variations underscore the importance of obtaining reliable and valid information from patients in evaluating the impact of TKA. The multi-disciplinary group of attendees at the conference will be tasked with establishing the current status of these three areas and with formulating pathways for future research. The conference will create an environment conducive for initiating collaboration among attendees by organizing presentations around important questions in all three areas, followed by ample discussion time. Experts have been chosen to speak to each question, but participation by attendees from all pertinent stakeholders (e.g., government agencies, third party payers, patient advocates, and orthopaedic device manufacturers) will ensure a wide perspective. To encourage active discussion, each topic will be discussed multiple times among different participants during breakout sessions. The momentum gained from the conference will extend beyond the time of the meeting through the publication of manuscripts on each of the three topics with emphasis on future directions for research. The findings of the conference will also be highlighted at the annual meetings and the websites of participating societies and organizations. The development of a research agenda for TKA is intended to stimulate individual investigators and multicenter collaborators to pursue impactful studies that will directy improve the satisfaction and outcomes for the hundreds of thousands of Americans who undergo TKA each year.